Provider Demographics
NPI:1467629089
Name:COMPLETE FAMILY EYECARE, LTD
Entity Type:Organization
Organization Name:COMPLETE FAMILY EYECARE, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-870-3010
Mailing Address - Street 1:1806 SWAMP PIKE
Mailing Address - Street 2:STE 400
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-9307
Mailing Address - Country:US
Mailing Address - Phone:610-323-4445
Mailing Address - Fax:610-323-4377
Practice Address - Street 1:1806 SWAMP PIKE
Practice Address - Street 2:STE 400
Practice Address - City:GILBERTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19525-9307
Practice Address - Country:US
Practice Address - Phone:610-323-4445
Practice Address - Fax:610-323-4377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001556152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty